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Negligence Litigation Against Nursing Homes Assessed

High-quality nursing homes sued only marginally less than low-performing ones

WEDNESDAY, March 30 (HealthDay News) -- High-quality nursing homes are sued for negligence only marginally less than low-performing nursing homes, according to an article published in the March 31 issue of the New England Journal of Medicine.

David M. Studdert, L.L.B., Sc.D., of the University of Melbourne in Australia, and colleagues linked information on tort claims brought against 1,465 nursing homes between 1998 and 2006 to indicators of nursing home quality compiled from the Online Survey, Certification, and Reporting system and the Minimum Data Set Quality Measure/Indicator Report. The investigators tested for relationships between the incidence of claims and the quality measures at the facility calendar-quarter level, correcting for facility clustering and adjusting for case mix, occupancy, ownership, state, and year.

Although the overall effects were relatively small, the investigators found that nursing homes with more deficiencies (odds ratio [OR], 1.09) and those with more serious deficiencies (OR, 1.04) had higher odds of being sued. The investigators also found that nursing homes with more residents with weight loss (OR, 1.05) and with pressure ulcers (OR, 1.09) had higher odds of being sued. Nursing homes with more nurse's aide-hours per resident-day had decreased odds of being sued (OR, 0.95).

"The results of this study raise questions about the capacity of tort litigation to provide incentives for improving the quality and safety of nursing home care. It is far from clear that superior performance will be rewarded with substantially lower risks of being sued," the authors write. "Policy moves that are afoot in the long-term care sector, such as public reporting of performance indicators and provider payments that are based on performance, may have brighter prospects for making nursing homes safer."

Several authors disclosed financial relationships with insurance companies, including the American Medical Risk Insurance Company.

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